Monday, November 18, 2013

Stuff Their Mouths with Gold

The Disease Management Care Blog uncovered this confidential memo, presumably authored by a health insurance CEO to the company's senior management team. Any resemblance to reality or perception is purely intentional.
DATE: November 18, 2013

TO: Senior Management

FROM: The Office of the CEO

RE: Our recent White House meeting on the individual mandate

As many of you are aware, I and other commercial insurance CEOs visited White House to barnstorm over ways to help President Obama out of his latest political pickle. While, like you, I was caught off-guard by the President's "I hear you loud and clear" proclamation, our trade association CEO, Karen Ignagni, was once again masterful in helping us understand the big picture. I wish to share that information with you.

1. Remember that the Affordable Care Act (ACA) is a commercial insurance gold-laying goose. Millions of Americans are being forced to buy our products, and a lot of them will be subsidized by the faith and credit of the Federal government. While the President will use every opportunity to deflect any blame on us, we must remember: eye on the prize, people!

2. While we would naturally prefer that, effective January 1 2014, our customers move from the skimpy lower margin individual plans to the richer and more profitable "essential health benefit" plans, Ms. Ignagni anticipated that the amateurs advising the President would lead to him to having to make stuff up on the fly. Think of this as the price of doing business.

3. While many of you will be working long hours through the upcoming holidays to un-disenroll the hundreds of thousands of insureds that got our cancellation nastygrams, let me assure you that getting it right most, not all of the time is our new business mantra. Sure, thousands of persons will allege that that they thought they were covered with X deductible for Y condition, but we can clean that up after the fact through the standard appeal process. Hey, it's right there on the White House web site.

4. It's no accident that Ms. Ignagni described our White House meeting as "very productive." While the details cannot be shared with you, as many of you know, the ACA allows for certain "risk corridor offsets" to be made if there are early death spirals in the mandated minimum benefit plans. While opponents of the ACA will attempt to undermine those costly offsets in the upcoming government budget battles, we're hopeful that politicians on both sides of the aisle will ultimately recognize that it's not our fault that the White House's insights on health insurance is about as deep as Toronto Mayor Rob Ford's awareness of the perils of crack.

5. We must remain quiet and outside the public eye. While all of us are appalled at the Administration's blunders, the last thing we want to do is to remind our Democratic allies about the "public option." If we are approached by the media, let's recall that Aneurin Bevan, the founder of the National Health Service, neutralized the opposition of Britain's doctors by "stuff[ing] their mouths with gold." The ACA is our gold and let's keep our dismay out of sight and our mouths silent.

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About Jaan Sidorov MD, MHSA, FACP

While his web persona has been described as a "blogvocateur," Dr. Sidorov has wide range of knowledge about the medical home, condition management, population-based health care and managed care that is only exceeded by his modesty. He has been quoted by the Wall Street Journal, Consumer Reports and NPR’s All Things Considered.
He has over 20 years experience in primary care, disease management and population based care coordination. He is a primary care general internist and former Medical Director at Geisinger Health Plan.
He is primary care by training, managed care by experience and population-based care strategies by disposition.
The contents of this blog reflect only the opinions of Sidorov and should not be interpreted to have anything to do with any current or past employers, clients, customers, friends, acquaintances or enemies, personal, professional, foreign or domestic. This is also not intended to function as medical advice. If you really need that, work with a personal physician or call 911 for crying out loud.
Jaan can be reached at jaansATaolDOTcom.